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Burns Flashcards Preview

What is TBSA?

- Total Body Surface Area

What is STSG?

- Split Thickness Skin Graft

3

Are acid or alkali chemical burns more serious?

- ALKALI burns because the body cannot buffer the alkali, thus allowing them to burn for much longer.

4

Why are electrical burns so dangerous?

- most of the destruction from electrical burns is internal because the route of least electrical resistance follows nerves, blood vessels, and fascia; injury is usually worse than external burns at entrance and exit sites would indicate; CARDIAC DYSRHYTHMIAS, myoglobinuria, acidosis, and renal failure are common.

What diagnostic imaging is used for smoke inhalation?

- bronchoscopy

What lab value assesses smoke inhalation?

- carboxyhemoglobin level (greater than 60% is associated with a 50% mortality). - treat with 100% O2 and time

35

How should the airway be managed in the burn patient with an inhalation injury?

- with a low threshold for intubation; oropharyngeal swelling may occlude the airway so that intubation is impossible; 100% oxygen should be administered immediately and continued until significant carboxyhemoglobin is ruled out.

36

What is burn shock?

- the loss of fluid from the intravascular space as a result of burn injury, which causes "leaking capillaries" that require crystalloid infusion

37

What is the parkland formula?

V= TBSA burn (%) x weight (kg) x 4 - used to estimate the volume (V) of cyrstalloid necessary for the initial resuscitation of the burn patient; half of the calculated volume is given in the FIRST 8 HOURS, the rest in the next 16 hours.

38

What burns qualify for the parkland formula?

- greater than 20% TBSA second and third-degree burns only

39

*** What is the Brooke formula for burn resuscitation?

- replace 2 cc for the 4 cc in the parkland formula

40

How is crystalloid given?

- through 2 large-bore peripheral venous catheters

41

Can you place an IV or central line through burned skin?

- YES

42

What is the adult urine output goal?

- 30-50 cc (titrate IVF)

43

Why is glucose-containing IVF contraindicated in burn patients in the first 24 hours postburn?

- patient's serum glucose will be elevated on its own because of the stress response

44

What fluid is used after the first 24 hours postburn?

- colloid; use D5W and 5% albumin at 0.5 cc/kg/% burn surface area

45

Why should D5W IV be administered after 24 hours postburn?

- because of the massive sodium load in the first 24 hours of lactated ringers infusion and because of the massive evaporation of H2O from the burn injury, the patient will need free water.- AFTER 24 hours, the capillaries begin to work and then the patient can usually benefit from ALBUMIN and D5W